Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $330.93 / $1,159.00 / $4,634.00	Facility		$330.93	$1,159.00	$4,634.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,300.62 / $4,300.62 / $4,300.62	Facility	50	$4,300.62	$4,300.62	$4,300.62
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $195.26 / $320.74 / $416.19	Facility	54	$195.26	$320.74	$416.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.04 / $330.93 / $677.76	Professional		$242.04	$330.93	$677.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $442.29 / $442.29 / $2,832.06	Professional	50	$442.29	$442.29	$2,832.06
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $175.65 / $248.20 / $391.33	Professional	54	$175.65	$248.20	$391.33
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $35.13 / $49.64 / $78.27	Professional	55	$35.13	$49.64	$78.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $215.52 / $215.52 / $220.22	Professional		$215.52	$215.52	$220.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $754.86 / $2,452.71 / $5,349.67	Facility		$754.86	$2,452.71	$5,349.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.64 / $412.29 / $513.73	Professional		$265.64	$412.29	$513.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $463.00 / $463.00 / $480.00	Facility		$463.00	$463.00	$480.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.87 / $393.44 / $576.51	Professional		$260.87	$393.44	$576.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $237.90 / $421.48 / $1,529.46	Professional		$237.90	$421.48	$1,529.46
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $280.67 / $283.70 / $386.59	Professional		$280.67	$283.70	$386.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $437.15	Professional		$32.34	$32.34	$437.15
United Facility/Professional Facility Modifier Low / Median / High Price $553.00 / $1,905.00 / $4,342.00	Facility		$553.00	$1,905.00	$4,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $306.12 / $450.41 / $687.21	Professional		$306.12	$450.41	$687.21